Post-graduate Program in Epidemiology, Departamento de Medicina Social, Faculdade de Medicina, Federal University of Pelotas, Pelotas, Brazil.
BMC Pregnancy Childbirth. 2013 Jan 23;13:20. doi: 10.1186/1471-2393-13-20.
To identify prognostic factors associated with recurrence of low birthweight (LBW) in successive gestations, a study was carried out with a subsample of mothers enrolled in the 2004 Pelotas Birth Cohort.
Data were collected by hospital-based interviews. Newborns were weighed and measured. Gestational age was defined according to the date of last menstrual period, ultra-sound scan before the 20th week of pregnancy or the Dubowitz method. Mothers who reported at least one LBW newborn in the two previous gestations were included. Prevalence ratios (PR) and 95% confidence intervals were estimated from Poisson Regression. All estimates were adjusted for parity.
A total of 4558 births were identified in 2004, and 565 met inclusion criteria, out of which 86 (15.2%) repeated LBW in 2004. Among mothers with two LBW babies before 2004, 47.9% presented LBW recurrence. Belonging to the highest socio-economic stratum (PR 0.89; 0.01-0.46) and gaining ≥ 10 kg during pregnancy (PR 0.09; 0.01-0.77) were protective against LBW recurrence. Higher risk of LBW recurrence was observed among mothers with higher parity (≥3 previous deliveries; PR=1.93; 95% CI 1.23-3.02); who had given birth to a previous preterm baby (PR=4.01; 2.27-7.10); who delivered a female newborn in current gestation (PR=2.61; 1.45-4.69); and that had not received adequate antenatal care (PR=2.57; 1-37-4.81).
Improved quality of antenatal care and adequate maternal weight gain during pregnancy may be feasible strategies to prevent LBW repetition in successive pregnancies.
为了确定与连续妊娠中低出生体重（LBW）复发相关的预后因素，对 2004 年佩洛塔斯出生队列中入组的部分母亲进行了一项研究。
通过基于医院的访谈收集数据。对新生儿进行称重和测量。根据末次月经日期、妊娠 20 周前的超声扫描或杜博维茨法来定义妊娠龄。将至少有一名前两次妊娠中 LBW 新生儿的母亲纳入研究。使用泊松回归估计患病率比（PR）和 95%置信区间。所有估计均按产次进行调整。
2004 年共发现 4558 例分娩，其中 565 例符合纳入标准，其中 86 例（15.2%）在 2004 年再次出现 LBW。在 2004 年前有两次 LBW 婴儿的母亲中，47.9%出现 LBW 复发。属于最高社会经济阶层（PR0.89；0.01-0.46）和孕期增重≥10kg（PR0.09；0.01-0.77）可预防 LBW 复发。较高的 LBW 复发风险见于具有较高产次（≥3 次分娩；PR1.93；95%CI1.23-3.02）的母亲；有过早产婴儿的母亲（PR4.01；2.27-7.10）；本次妊娠分娩女婴的母亲（PR2.61；1.45-4.69）；以及未接受足够产前保健的母亲（PR2.57；1-37-4.81）。
提高产前保健质量和孕期适当增重可能是预防连续妊娠中 LBW 重复的可行策略。
